When a newborn suffers a stroke during or shortly after birth, families face devastating consequences that can last a lifetime. Neonatal stroke is a serious medical emergency that affects approximately 1 in 2,500 to 4,000 live births in the United States, making it as common as stroke in adults but with unique challenges for diagnosis and treatment.
If your child experienced a neonatal or perinatal stroke due to medical negligence in New York, you have legal rights to pursue compensation. This comprehensive guide explains what neonatal stroke is, how medical malpractice can cause or worsen these injuries, and your options for holding healthcare providers accountable.
What Is a Neonatal Stroke?
A neonatal stroke is a disruption of blood flow to the brain that occurs in a newborn within the first 28 days of life. When the term “perinatal stroke” is used, it refers to strokes occurring from 22 weeks of gestation through the first 7 days after birth.
Important Distinction: “Perinatal” covers 22 weeks gestation through 7 days postnatal, while “neonatal” specifically refers to the first 28 days after birth. Both terms are often used interchangeably in medical malpractice cases.
Types of Neonatal Stroke
There are two primary types of stroke that can affect newborns:
Ischemic Stroke: This occurs when blood flow to part of the brain is blocked, typically by a blood clot. Perinatal arterial ischemic stroke (PAIS) is the most common form and accounts for the majority of neonatal stroke cases.
Hemorrhagic Stroke: This happens when a blood vessel in the brain ruptures and bleeds. While less common than ischemic stroke, hemorrhagic strokes can be equally devastating.
According to recent medical research published in 2024-2025, perinatal arterial ischemic stroke occurs in approximately 1 in 2,300 to 5,000 live births among full-term infants. In preterm infants born at or before 34 weeks gestation, the rate is significantly higher at 7 per 1,000 births.
Causes and Risk Factors for Neonatal Stroke
While the exact cause of many neonatal strokes remains unknown, researchers have identified numerous risk factors that increase the likelihood of stroke occurring during or shortly after birth.
Maternal Risk Factors
Several maternal conditions can increase the risk of neonatal stroke:
- Autoimmune disorders: Conditions affecting the mother’s immune system can impact blood clotting
- Coagulation disorders: Blood clotting abnormalities that can be passed to the infant
- Diabetes: Uncontrolled gestational or pre-existing diabetes
- Infections: Maternal infections during pregnancy, including chorioamnionitis
- Prenatal substance exposure: Particularly cocaine use during pregnancy
- Trauma: Physical trauma during pregnancy
Placental Complications
Placental disorders significantly increase stroke risk and often indicate potential medical negligence:
- Placental abruption: When the placenta separates from the uterine wall prematurely
- Placental thrombosis: Blood clots in the placenta
- Placental infection: Bacterial or viral infections affecting the placenta
- Chorioamnionitis: Infection of the fetal membranes and amniotic fluid
Fetal and Neonatal Risk Factors
- Congenital heart disease: Structural heart defects present at birth
- Blood clotting disorders: Inherited conditions affecting coagulation
- Infections: Sepsis or meningitis in the newborn period
- Hypoxia: Oxygen deprivation during labor and delivery
2025 Research Finding: A recent study in Frontiers in Pediatrics found a notable correlation between failed labor trials resulting in cesarean sections and the incidence of perinatal arterial ischemic stroke, suggesting complications during labor significantly increase risk.
How Medical Negligence Can Cause Neonatal Stroke
Not all neonatal strokes result from medical malpractice, but healthcare providers have a duty to recognize risk factors, monitor for signs of fetal distress, and respond appropriately to prevent or minimize brain injury.
Common Forms of Medical Negligence
| Type of Negligence | How It Contributes to Stroke |
|---|---|
| Failure to Monitor Fetal Heart Rate | Missing signs of oxygen deprivation that could lead to ischemic stroke |
| Delayed Emergency C-Section | Prolonging oxygen deprivation when fetal distress is evident |
| Excessive Force with Delivery Instruments | Forceps or vacuum extractor misuse causing hemorrhagic stroke |
| Failure to Diagnose Maternal Infections | Untreated infections increasing blood clot formation risk |
| Mismanagement of Placental Abruption | Failing to recognize and respond to placental separation emergencies |
| Inadequate Screening for Risk Factors | Missing maternal coagulation disorders or congenital heart defects |
The Standard of Care
To establish medical malpractice in a neonatal stroke case, your attorney must prove that the healthcare provider deviated from the accepted standard of care. This means showing that another competent medical professional in the same situation would have acted differently and that this deviation directly caused or worsened the stroke.
Expert medical testimony is essential in these cases to establish what a reasonable healthcare provider should have done under the circumstances.
Signs and Symptoms of Neonatal Stroke
One of the greatest challenges with neonatal stroke is that symptoms can be subtle or delayed. Research shows that one-third to one-half of all newborns with neonatal stroke have a normal newborn examination record.
Immediate Symptoms (Birth to 28 Days)
The most common sign of neonatal stroke is seizures, which occur in the majority of affected infants. Other immediate symptoms include:
- Seizures or abnormal movements: The most frequent presenting symptom
- Apnea: Periods where the baby stops breathing
- Lethargy: Excessive sleepiness or difficulty arousing
- Feeding difficulties: Problems with sucking or swallowing
- Abnormal muscle tone: Either too stiff or too floppy
- Breathing problems: Respiratory distress requiring intervention
Delayed Symptoms (Months to Years Later)
In many cases, the full impact of a neonatal stroke doesn’t become apparent until developmental milestones are missed:
- Hemiplegia: Weakness or paralysis on one side of the body
- Delayed motor development: Late to roll over, sit, crawl, or walk
- Asymmetric hand use: Preferring one hand much earlier than typical
- Vision problems: Visual field defects or cortical visual impairment
- Cognitive delays: Learning difficulties that emerge in early childhood
Critical Window: Early diagnosis and intervention can significantly improve outcomes. If your newborn exhibits any concerning symptoms, immediate neuroimaging with MRI is the gold standard for diagnosis.
Diagnosis of Neonatal Stroke
When neonatal stroke is suspected, medical professionals should act quickly to confirm the diagnosis and begin treatment.
Diagnostic Tools
Magnetic Resonance Imaging (MRI): The gold standard for diagnosing ischemic perinatal stroke. MRI provides detailed images of brain tissue and can identify areas of damage.
Cranial Ultrasound: Often the first imaging test performed because it can be done at the bedside. While less detailed than MRI, it can detect hemorrhagic strokes and some large ischemic strokes.
CT Scan: Computed tomography can quickly identify bleeding or blockages but involves radiation exposure.
Electroencephalogram (EEG): Records brain electrical activity to identify seizures and abnormal patterns.
Blood Tests: Can identify infections, clotting disorders, and metabolic problems that may contribute to stroke.
Treatment Options for Neonatal Stroke
The critical time window for treatment is narrow, making rapid diagnosis essential. Current treatment approaches include:
Acute Treatment (First 72 Hours)
Therapeutic Hypothermia (Cooling Therapy): An emerging treatment that involves cooling the infant’s head or whole body for up to 72 hours after birth. Studies have shown this can reduce fatality rates and minimize brain damage when initiated within 6 hours of birth.
A 2024 study published in Pediatric Research found that among infants receiving therapeutic hypothermia for hypoxic-ischemic encephalopathy, 4% were also diagnosed with perinatal arterial ischemic stroke, with 76% showing concurrent brain injury patterns.
Anticoagulants: In some cases of ischemic stroke caused by blood clots, carefully monitored anticoagulant therapy may be used.
Seizure Management: Controlling seizures is critical to prevent further brain injury.
Supportive Care: Maintaining stable blood pressure, glucose levels, and oxygenation.
Long-Term Treatment and Rehabilitation
- Physical therapy: To address motor delays and hemiplegia
- Occupational therapy: To improve fine motor skills and daily living activities
- Speech therapy: For language delays and feeding difficulties
- Anti-seizure medications: Long-term management if epilepsy develops
- Vision therapy: For visual impairments
- Assistive devices: Braces, walkers, or wheelchairs as needed
- Educational interventions: Special education services and accommodations
Long-Term Consequences of Neonatal Stroke
The impact of neonatal stroke varies widely, but research shows approximately 60% of children who experience perinatal stroke will have some degree of permanent neurological deficit.
Cerebral Palsy
Perinatal stroke is the most common identifiable cause of hemiparetic cerebral palsy. Research indicates that 68% of children who experienced perinatal stroke eventually developed cerebral palsy.
Epilepsy
Many neonatal stroke survivors develop seizure disorders that require lifelong medication and monitoring. The risk varies based on stroke location and severity.
Cognitive Impairments
Learning disabilities, attention problems, and intellectual disabilities can result from neonatal stroke, though many children have normal intelligence.
Behavioral Challenges
Behavioral and emotional difficulties, including ADHD, anxiety, and social skills deficits, are more common in stroke survivors.
It’s important to note that outcomes are highly variable. According to medical literature, most children who had a perinatal stroke will be able to walk, and with early intervention and appropriate therapies, many can lead fulfilling lives.
Filing a Neonatal Stroke Lawsuit in New York
If medical negligence caused or contributed to your child’s neonatal stroke, you have the right to pursue a birth injury lawsuit in New York.
New York Statute of Limitations for Birth Injuries
Understanding the deadlines for filing a lawsuit is crucial:
Standard Medical Malpractice Timeline: New York’s standard statute of limitations for medical malpractice is 2.5 years from the date of the negligent act under New York Civil Practice Law & Rules § 214-a.
Infancy Toll Extension: Because birth injury cases involve children, New York provides a special extension. Under CPLR Section 208, the statute of limitations is tolled (paused) during the child’s minority, giving parents up to 10 years from the date of birth to file a claim for neurological birth injuries.
Discovery Rule: If the injury wasn’t immediately apparent, the 2.5-year timeline may begin when the injury was discovered or reasonably should have been discovered.
Important Exception: If your child was born at a New York City municipal hospital (NYC Health + Hospitals), you must file a formal Notice of Claim with the proper agency within just 90 days of the injury. Missing this deadline can permanently bar your claim.
What You Can Recover in a Neonatal Stroke Lawsuit
New York law allows families to seek compensation for both economic and non-economic damages:
| Type of Damages | What’s Included |
|---|---|
| Past Medical Expenses | Hospital bills, NICU care, imaging, medications, and emergency treatment |
| Future Medical Care | Lifetime costs of therapy, medications, surgeries, and medical equipment |
| Rehabilitation Costs | Physical, occupational, and speech therapy over the child’s lifetime |
| Assistive Devices | Wheelchairs, braces, communication devices, and adaptive technology |
| Special Education | Costs of specialized schooling and educational support |
| Lost Earning Capacity | Compensation for reduced future earning potential due to disabilities |
| Pain and Suffering | Compensation for the child’s physical pain and emotional distress |
| Parental Loss of Services | Parents’ loss of their child’s companionship and services |
Proving Medical Malpractice in Neonatal Stroke Cases
To succeed in a neonatal stroke lawsuit, your attorney must establish four key elements:
1. Duty of Care: The healthcare provider had a doctor-patient relationship with you and your baby, creating a duty to provide competent care.
2. Breach of Duty: The provider failed to meet the accepted standard of care. This requires expert testimony from qualified medical professionals who can explain what should have been done differently.
3. Causation: The breach of duty directly caused or significantly worsened the neonatal stroke and resulting injuries. This is often the most challenging element to prove.
4. Damages: Your child suffered real, compensable injuries with documented medical and financial consequences.
The Certificate of Merit Requirement
New York law requires plaintiffs in medical malpractice cases to file a Certificate of Merit within 90 days after filing the lawsuit. This certificate, signed by a qualified medical expert, confirms that the expert has reviewed the case and believes there is a reasonable basis for the malpractice claim.
There are no exceptions or extensions for this requirement, making it essential to work with an experienced birth injury attorney who understands these procedural requirements.
Building a Strong Neonatal Stroke Case
Successful neonatal stroke lawsuits require comprehensive evidence and expert testimony:
Essential Evidence
- Complete medical records: Prenatal care, labor and delivery notes, fetal monitoring strips, NICU records
- Imaging studies: MRI, CT scans, and ultrasounds showing the stroke
- Expert witness testimony: Obstetricians, neonatologists, and pediatric neurologists
- Life care plan: Detailed analysis of your child’s future medical and care needs
- Economic expert analysis: Calculation of lifetime costs and lost earning capacity
- Developmental evaluations: Documentation of delays and disabilities
The Role of Expert Witnesses
Expert witnesses are critical in neonatal stroke cases. Your attorney will typically need:
Medical Expert: A physician qualified to testify about the standard of care during pregnancy, labor, and delivery. This expert explains what the healthcare providers should have done and how their actions fell short.
Causation Expert: Often a pediatric neurologist who can connect the medical negligence to the stroke and resulting injuries.
Life Care Planning Expert: A specialist who can project your child’s future medical needs and associated costs.
Economic Expert: Calculates the financial impact, including lost earning capacity and lifetime care costs.
Settlement vs. Trial in Neonatal Stroke Cases
Many medical malpractice cases settle before trial, but understanding both paths is important:
Settlement Benefits
- Faster resolution: Trials can take years; settlements often resolve within 12-18 months
- Certainty: You know exactly what you’ll receive rather than risking a jury verdict
- Lower costs: Avoiding trial reduces expert fees and litigation expenses
- Privacy: Settlement terms can be confidential
- Less stress: Families avoid the emotional toll of testifying at trial
When Going to Trial Makes Sense
- Settlement offer is inadequate: Doesn’t cover your child’s lifetime needs
- Liability is clear: Strong evidence of negligence makes a jury verdict likely
- Damages are substantial: Cases with severe, permanent injuries may warrant higher jury awards
- Defendant refuses reasonable settlement: Some cases require trial to achieve justice
No Upfront Costs: Birth injury attorneys in New York typically work on a contingency fee basis, meaning you pay nothing unless you recover compensation. Legal fees come from the settlement or verdict, typically 30-40% of the total recovery.
Taking Action: Next Steps for Families
If you suspect your child’s neonatal stroke resulted from medical negligence, taking prompt action is essential:
Immediate Steps
1. Secure Medical Records: Request complete copies of all prenatal, labor, delivery, and neonatal records. You have a legal right to these documents.
2. Document Everything: Keep detailed notes about your child’s symptoms, diagnoses, treatments, and medical appointments.
3. Consult a Birth Injury Attorney: Most offer free case evaluations and can quickly assess whether you have a viable claim.
4. Don’t Discuss the Case: Avoid discussing potential malpractice with healthcare providers or posting on social media, as these statements can be used against you.
5. Continue Medical Care: Follow all recommended treatments and therapies for your child. Gaps in care can be used to argue you haven’t mitigated damages.
What to Expect During a Free Consultation
When you meet with a birth injury attorney, they’ll want to understand:
- The circumstances of your pregnancy, labor, and delivery
- When symptoms of stroke first appeared
- What medical providers have said about the cause
- Your child’s current condition and prognosis
- Whether you’ve stayed within the statute of limitations
The attorney will review available medical records and may have them examined by a medical expert before deciding whether to take your case.
Frequently Asked Questions About Neonatal Stroke Lawsuits
How long do I have to file a neonatal stroke lawsuit in New York?
Under New York law, you generally have up to 10 years from your child’s date of birth to file a birth injury lawsuit due to the “infancy toll” provision that pauses the statute of limitations during childhood. However, there are important exceptions: if your child was born at a NYC municipal hospital, you must file a Notice of Claim within 90 days. Because these deadlines can be complex, consult with a birth injury attorney as soon as you suspect medical negligence.
What is the difference between a neonatal stroke and HIE?
Hypoxic-ischemic encephalopathy (HIE) is brain damage caused by oxygen deprivation and reduced blood flow, while neonatal stroke is a specific disruption of blood flow to a particular area of the brain. They can occur together—research shows that 4% of infants treated for HIE are also diagnosed with perinatal arterial ischemic stroke. Both conditions can result from medical negligence during labor and delivery, but they involve different injury patterns and may have different long-term outcomes.
Can a baby fully recover from a neonatal stroke?
Recovery varies significantly based on the stroke’s location, size, and severity. While some infants experience minimal long-term effects, approximately 60% will have some permanent neurological deficit. Research shows that 68% of children who experience perinatal stroke develop cerebral palsy. However, with early intervention and intensive therapy, many children achieve significant functional improvements. Most children who had a perinatal stroke will be able to walk, and outcomes continue to improve with advances in early treatment and rehabilitation.
What compensation can I receive for my child’s neonatal stroke?
If medical negligence caused your child’s stroke, you may recover damages for past and future medical expenses, rehabilitation costs, assistive devices, special education, lost future earning capacity, pain and suffering, and loss of parental services. New York doesn’t cap damages in medical malpractice cases (except for wrongful death non-economic damages), so compensation is based on your child’s actual needs and losses. Successful birth injury cases can result in multi-million dollar settlements or verdicts to cover lifetime care costs.
How do I prove the doctors were negligent?
Proving negligence requires showing that healthcare providers breached the standard of care and that this breach caused your child’s stroke. This involves expert medical testimony from qualified physicians who review your medical records and explain what should have been done differently. Common examples include failure to monitor fetal heart rate patterns, delayed response to signs of fetal distress, improper use of delivery instruments, or failure to perform a timely emergency C-section. Your attorney will work with medical experts to build this case.
What if the stroke wasn’t diagnosed until months or years after birth?
Many neonatal strokes aren’t diagnosed immediately because symptoms can be subtle or delayed. Approximately one-third to one-half of newborns with stroke have normal initial examinations. You may still have a viable claim even if the diagnosis came later. New York’s discovery rule may extend the statute of limitations to 2.5 years from when the injury was discovered or should have been discovered. Additionally, the 10-year infancy toll provides protection for delayed diagnoses. Consult an attorney to understand how the timing affects your specific case.
Do I need a lawyer who specializes in birth injuries?
Yes, neonatal stroke cases are among the most complex medical malpractice claims. They require attorneys with specific experience in birth injury law who understand obstetrical standards of care, have relationships with qualified medical experts, and can accurately calculate lifetime care costs for children with neurological disabilities. General personal injury attorneys typically lack this specialized knowledge. Look for a law firm with a proven track record in birth injury cases, particularly those involving neonatal stroke or cerebral palsy.
What happens if my child’s condition worsens as they get older?
The full extent of neonatal stroke injuries often doesn’t become apparent until children reach developmental milestones. A structured settlement or verdict should account for lifetime needs, including care that will be required as your child ages. This is why life care planning experts are essential—they project future medical needs, therapies, assistive devices, and care costs throughout your child’s expected lifespan. If you’ve already settled a case and new complications arise, you typically cannot reopen the claim, which is why thorough evaluation of future needs is critical before accepting any settlement.
Why Legal Representation Matters
Neonatal stroke cases involve complex medical and legal issues that require specialized expertise. Hospitals and healthcare providers have experienced defense attorneys and insurance companies protecting their interests from the moment a potential claim emerges.
An experienced birth injury attorney levels the playing field by:
- Identifying all potentially liable parties (physicians, hospitals, nurses, midwives)
- Securing qualified medical experts to review your case
- Obtaining and analyzing complex medical records
- Calculating the full value of your claim, including lifetime care costs
- Navigating procedural requirements like the Certificate of Merit
- Negotiating with insurance companies who want to minimize payouts
- Preparing for trial if a fair settlement cannot be reached
Most importantly, your attorney handles the legal complexities while you focus on what matters most: caring for your child.
Moving Forward After Neonatal Stroke
Learning that your child suffered a neonatal stroke is devastating, and the journey ahead will have challenges. But with the right medical care, early intervention, and legal advocacy, many children with stroke injuries can achieve meaningful progress and improved quality of life.
If medical negligence played a role in your child’s injury, pursuing a birth injury lawsuit isn’t just about compensation—it’s about accountability, justice, and ensuring your child has the resources needed for the best possible future.
Time Is Critical: While New York provides up to 10 years to file birth injury claims, starting the legal process early offers advantages. Evidence is fresher, witnesses’ memories are clearer, and you can begin securing compensation for ongoing care costs sooner. Don’t wait until you’re approaching the deadline to seek legal guidance.
The legal process may seem overwhelming, but you don’t have to navigate it alone. Qualified birth injury attorneys offer free case evaluations, work on contingency (no upfront costs), and have the resources to take on complex medical malpractice cases against well-funded defendants.
Your child deserves every opportunity to thrive despite the challenges caused by neonatal stroke. Legal action can provide the financial resources to access the best therapies, medical care, and support services available—making a real difference in your child’s future.
